Individual
STEPHANIE MARIN JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC-MHSP
Contact information
Practice address
1611 RAILROAD ST, DAYTON, TN 37321-1044
(423) 570-7300
Mailing address
1781 KIUKA RD, DAYTON, TN 37321-7492
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
4567
TN
Other
Enumeration date
04/13/2019
Last updated
04/13/2019
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